Macaenes, which are a class of bioactive compounds found in Maca (Lepidium meyenii), have traditionally been used as part of Maca root preparations in Peruvian folk medicine. Maca has a long history of use for enhancing fertility, energy, and hormonal balance, including alleviating symptoms related to the menstrual cycle such as premenstrual syndrome (PMS). The traditional use is rooted in indigenous Andean practices, where Maca is consumed as a food and natural remedy for reproductive health. However, the specific use of macaenes, as isolated compounds, for PMS is not strongly supported by traditional records—rather, it is the whole Maca root that is referenced. Scientific investigations into Maca and its constituents, including macaenes, for PMS are limited. A few small clinical trials have suggested that Maca root may help reduce psychological symptoms of PMS, such as mood swings and anxiety, but these studies are few, often of low quality, and rarely focus on macaenes specifically. Most available evidence attributes potential benefits to the whole root, and not to isolated compounds like macaenes. Overall, while there is a traditional precedent for using Maca (and thus macaenes by extension) for PMS, the scientific evidence is still preliminary and not robust. Hence, the justification is primarily traditional, and the evidence rating is low.